Combination Chemotherapy, Autologous Stem Cell Transplant, and/or Radiation Therapy in Treating Young Patients With Extraocular Retinoblastoma

Inclusion Criteria:

   - Patients must have histologic or cytologic verification of extra-ocular
   retinoblastoma; extra-ocular disease includes orbital disease, optic nerve involvement
   at the surgical margin, regional nodal disease, and/or overt distant metastatic
   disease (at sites such as bone, bone marrow, liver and/or the central nervous system);
   patients with trilateral retinoblastoma will also be included in this protocol

      - Patients with a CNS lesion consistent with trilateral or stage 4b disease may be
      enrolled without tissue confirmation if (1) unequivocal leptomeningeal disease is
      present on brain or spine magnetic resonance imaging (MRI) scan and/or (2) the
      primary tumor is at least 2 cm in diameter, predominantly solid, and demonstrates
      enhancement on the post-gadolinium images; however, even in such cases surgery
      should be given serious consideration

   - Patients must have a performance status corresponding to Eastern Cooperative Oncology
   Group (ECOG) scores of 0, 1, or 2; use Karnofsky for patients > 16 years of age and
   Lansky for patients =< 16 years of age

   - No prior chemotherapy or radiotherapy for the extra-ocular retinoblastoma may have
   been administered prior to entering this study; prior treatment (chemotherapy and/or
   radiation therapy) for intra-ocular retinoblastoma is permissible

   - Peripheral absolute neutrophil count (ANC) >= 750/uL

      - If the ANC and/or platelet count are not adequate, but due to bone marrow
      metastatic disease, these criteria will be waived

   - Platelet count >= 75,000/uL (transfusion independent)

      - If the ANC and/or platelet count are not adequate, but due to bone marrow
      metastatic disease, these criteria will be waived

   - Creatinine clearance OR radioisotope glomerular filtration rate >= 70 mL/min/1.73 m^2
   or a serum creatinine based on age/gender as follows:

      - 0.4 mg/dL (1 month to < 6 months of age)

      - 0.5 mg/dL (6 months to < 1 year of age)

      - 0.6 mg/dL (1 years to < 2 years of age)

      - 0.8 mg/dL (2 years to < 6 years of age)

      - 1.0 mg/dL (6 years to < 10 years of age)

      - 1.2 mg/dL (10 years to < 13 years of age)

      - 1.5 mg/dL (male) or 1.4 mg/dL (female) (13 years to < 16 years of age)

      - 1.7 mg/dL (male) or 1.4 mg/dL (female) (>= 16 years of age)

   - Total bilirubin =< 1.5 times upper limit of normal (ULN)

   - Serum glutamic oxaloacetic transaminase (SGOT) (aspartate aminotransferase [AST]) or
   serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase [ALT]) < 2.5 x
   upper limit of normal (ULN)

   - All patients and/or their parents or legal guardians must sign a written informed
   consent

   - All institutional, Food and Drug Administration (FDA), and National Cancer Institute
   (NCI) for human studies must be met